Pain

Comment by Dr. Navneet Bidani on December 28, 2009 at 12:47am

All that we are is the result of what we have thought. If a man speaks or acts with an evil thought, pain follows him. If a man speaks or acts with a pure thought, happiness follows him, like a shadow that never leaves him.
Buddha

Dear Madeeha, here is my understanding of 'PAIN'

Definition: Any uneasy sensation in animal bodies, from slight uneasiness to extreme distress or torture, proceeding from a derangement of functions, disease, or injury by violence; bodily distress; bodily suffering; an ache; a smart.

TYPES & DESCRIPTION of PAIN.

Ache : a pain that is steady, dull, and not too strong. An ache may be local, as a stomach ache, headache, or bone ache. It may be general, as the ache of the flu.

Boring : dull and advancing steadily, burrowing

Burning: like a hot poker stuck in you

Cutting: sharply penetrating, shearing or piercing, like being cut with a knife

Darting: rapid, sudden and swift, with or without changing direction

Digging: forcefully thrusting against, like something was being dug out of you with a knife.

Drawing: pulling or stiffening up, like something was pulling hard on the painful part.

Fulgurating: lightning-like; sudden and excruciating

Gnawing: chewing or eroding in a persistent manner, like something was chewing on you

Lancinating: piercing, stabbing, or sharply cutting, like being sliced with a lancet.

Pressing: like something was pushing hard on you.

Rending: tearing, splitting, bursting, or coming apart

Shooting: passing through swiftly, rapidly or suddenly

Sore: like a bruise

Stabbing: like a knife stab

Stiching: like a needle sewing

Sticking: pricking (similar to stitches)

Stitching: sudden sharp tearing, pricking, usually of momentary duration


Physiology of Pain:
Pain begins at special pain receptors scattered throughout the body. These pain receptors transmit messages as electrical impulses along nerves to the spinal cord and then upward to the brain. Sometimes the signal evokes a reflex response when it reaches the spinal cord; when this happens, a signal is immediately sent back along motor nerves to the original site of the pain, triggering the muscles to contract. An example of a reflex response is the immediate pull-away reaction upon inadvertently touching something very hot. The pain signal is also relayed to the brain. Only when the brain processes the signal and interprets it as pain does a person become consciously aware of it.

Pain receptors and their nerve pathways differ in different parts of the body. Because of this, pain sensation varies with the type and location of injury. For example, pain receptors in the skin are plentiful and capable of transmitting precise information, such as where an injury is located and whether the cause was sharp such as a knife wound or dull such as pressure, heat, or cold. In contrast, pain signals from the intestine are limited and imprecise. The intestine can be pinched, cut, or burned without generating a pain signal. However, stretching and pressure can cause severe intestinal pain, even from something as relatively harmless as a trapped gas bubble. The brain can't identify the precise source of intestinal pain; rather, the pain is difficult to locate and is likely to be felt over a large area.

Pain felt in some areas of the body may not accurately represent where the trouble is, because pain can be referred to another area. Referred pain happens because signals from several areas of the body often lead into the same nerve pathways going to the spinal cord and brain. For example, pain from a heart attack may be felt in the neck, jaws, arms, or abdomen, and pain from a gallbladder attack may be felt in the shoulder.

People differ remarkably in their ability to tolerate pain. One person may find the pain of a small cut or bruise intolerable, while another person can tolerate a major accident or knife wound with little complaint. Ability to withstand pain varies according to mood, personality, and circumstance. In a moment of excitement during an athletic match, an athlete may not notice a severe bruise but will likely be very aware of the pain after the match, particularly if the team lost.

Pain may even change with age. As people age, they complain less of pain, perhaps because changes in the body decrease the sensation of pain. On the other hand, the elderly may simply be more stoic than younger people.

Evaluation of Pain:
Pain may be sharp or dull, intermittent or constant, throbbing or consistent, at a single site or all over. Some pains are very difficult to describe in words. The intensity can vary from minor to intolerable. No laboratory test can prove the presence or severity of pain.A doctor asks about the history of the pain to fully understand its characteristics. Sometimes a scale of 0 (none) to 10 (severe) is used to help people describe their pain. For children, drawings of faces in a series--from smiling to frowning and crying--serve the same purpose. Doctors always try to determine both the physical and psychologic causes of pain. Many chronic diseases (such as cancer, arthritis, or sickle cell anemia) and acute disorders (such as wounds, burns, torn muscles, broken bones, sprained ligaments, appendicitis, kidney stones, or a heart attack) cause pain. Yet, psychologic illness (such as depression and anxiety) can also cause pain, called psychogenic pain. Psychologic factors may also make the pain of a physical injury appear more or less intense. A doctor must consider these issues.

Doctors also consider whether pain is acute or chronic. Acute pain is pain that begins suddenly and usually doesn't last long. When severe, it may cause a rapid heartbeat, increased breathing rate, elevated blood pressure, sweating, and dilated pupils. Chronic pain is pain that lasts for weeks or months; the term usually describes pain that persists for more than 1 month beyond the usual course of an illness or injury, pain that recurs off and on over months or years, or pain that's associated with a long-term disease such as cancer. Chronic pain usually doesn't affect the heartbeat, breathing rate, blood pressure, or pupils, but it may disturb sleep, decrease appetite, and cause constipation, weight loss, loss of interest in sexual activity, and depression.

Comment by Madeeha Jabeen on December 28, 2009 at 5:48am

thanks Dr.Navneet,
its really informative for me

Comment by Dr Muhammed Rafeeque on January 14, 2010 at 1:17am

SCIENCE BEHIND PAIN

Pain is a feeling of distress, suffering or agony caused by stimulation of specialized nerve endings by various chemical, physical or biological agents. These nerve endings are stimulated by inflammation, pressure, tension, injury, heat, cold, chemicals etc. resulting in pain. Each cell contains histamine and plasma kinins, which are hormone like substances released in to the extra cellular parts by the influence of noxious agents mentioned above. These chemical mediators increase the permeability of sensory nerves and the nerve impulses are carried via the sensory tracts to the brain and the subject perceives the sensation of pain and reacts to it. In case of sudden pain there will be an immediate response by the motor cells in the spinal cord even without the involvement of brain, which is called reflex action. The pain is actually a protective mechanism, which helps to identify any external agents or any lesions within the body. However it creates great agony for the sufferers and usually forces them to go for a medical consultation.

Comment by Madeeha Jabeen on January 14, 2010 at 4:37am

thanks for sharing sir:)

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